Advance decision to refuse treatment

You can make an advance decision to refuse treatment if you are aged 18 years or above and have mental capacity.

You can decide that you do not want a particular type of medical treatment if it was ever needed in the future and you lacked capacity at that time. Friends and family should be informed of your decision so that they can speak on your behalf.

Making sure your decision is valid

It is important when you are making an advance decision to ensure it is ‘valid and applicable’.

We strongly advise that you complete the advance decision card (PDF, 143KB) which you should carry with you in a purse or wallet to alert others to the fact an advance decision exists. Health staff will then know who to contact for the information. If doctors know you have made a valid advance decision to refuse treatment, they have to respect it.

Advance decisions and advance care planning

An advance decision to refuse treatment is different to “advanced care planning” in ‘end of life’ care. Advance decisions to refuse treatment are legally binding. Many parts of advance care planning are not.

Best interests decisions

Anything that is not part of your 'advance decision to refuse treatment' will be considered as 'in your best interests', but could be overridden by a doctor or social care professional if they determine it not to be in your ‘best interests’.

What your advance decision must include

Your advance decision can be verbal or written, it must clearly state

  • the exact treatments you want to refuse
  • the circumstances in which you want to refuse them

It is important that you fully understand the implications of refusing a particular treatment from a medical professional.

Refusing life-sustaining treatment

If you are refusing life-sustaining treatment, your advance decision must:

  • be in writing
  • be signed and witnessed
  • clearly state that the decision applies even if your life is at risk

Give copies to your family or close friends, and to your GP or social worker.

Changing your decision

You can change your mind and alter or cancel your advance decision at any time as long as you have capacity.

If medical advances mean that the outcome of a treatment is quite different to what was known when your advance decision was made, the validity may be challenged.

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Page last reviewed: 18 June 2025